Table of Content

28 October 2016, Volume 20 Issue 44 Previous Issue    Next Issue

For Selected:

Download Citations EndNote Reference Manager ProCite BibTeX RefWorks

Toggle Thumbnails

Select

Comparison of stress distribution of adjacent segments after artificial cervical disc replacement versus anterior cervical discectomy and fusion: a finite element analysis Liu Ya-pu, Hou Xiu-wei, Wu Guang-liang, Xia Hong 2016, 20 (44):  6541-6548.  doi: 10.3969/j.issn.2095-4344.2016.44.001 Abstract ( 411 )   PDF (1231KB) ( 348 )   Save BACKGROUND: Previous clinical follow-up study showed that disc degeneration of adjacent segment after anterior cervical discectomy and fusion was faster than that of artificial cervical disc replacement. Compared with the anterior cervical discectomy and fusion, artificial cervical disc replacement can maintain a good range of motion of replacement segment. Further investigation should be taken to compare the difference between stress and fusion after replacement.  OBJECTIVE: To compare the adjacent level discs loads between artificial cervical disc replacement and anterior cervical discectomy and fusion. METHODS: A healthy 30-year-old male volunteer was scanned with CT at the artificial cervical intervertebral disc and anterior cervical plate. Three-dimensional images were reconstructed with Mimics 10.01 and Geomagic Studio.v11 software. Above three-dimensional data were input into the Abaqus6.9 finite element analysis software for meshing, assignment, and stress analysis. Finite element method was used to simulate the stress changes of the adjacent segments after artificial cervical disc replacement and anterior cervical discectomy and fusion.  RESULTS AND CONCLUSION: (1) Under the same preload, during anteflexion, posterior extension, and lateroflexion, the disc stress at adjacent segment was significantly larger after anterior cervical discectomy and fusion than normal disc. Compared with normal persons, no significant difference was detected in stress of adjacent segment at anteflexion, posterior extension, and lateroflexion after artificial cervical disc replacement. (2) Compared with artificial cervical disc replacement group, the stress of adjacent segment increased 10.3%-51.6% in the anterior cervical discectomy and fusion group. (3) Finite element analysis showed that the stress was larger in the anterior cervical discectomy and fusion group than in the artificial cervical disc replacement group. With prolonged follow-up, compared with the conventional anterior decompression and fusion, artificial cervical disc replacement can better play its protective effect on the adjacent intervertebral disc. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

Select

Vacuum sealing drainage combined with iodophor douche for the prosthesis infection after artificial joint replacement Zhang Yang-chun, Xiao Jian-hong, Zhang Zi-ji, Yang Xing, Yu Shi-ming, Sheng Pu-yi 2016, 20 (44):  6549-6556.  doi: 10.3969/j.issn.2095-4344.2016.44.002 Abstract ( 316 )   PDF (1744KB) ( 336 )   Save BACKGROUND: Periprosthetic infection after artificial joint replacement is a disastrous complication for a patient. Currently, during treating for the periprosthetic infection, most of patients need two-stage revision, which bring about enormous physical and psychological pain for patients, and a heavy burden for the families and society. To make matters worse, the effect is not very perfect, and some of these cases require multi-stage revision, even amputation. OBJECTIVE: To investigate the therapeutic effect of vacuum sealing drainage combined with iodophor douche for the infection after artificial joint replacement. METHODS: Nine cases (six knees and three hips) of infection after artificial joint replacement were collected, with an average age of 63.4 years. Infection occurred at 7 days-14 months, and a median time of 1 month after replacement. All patients suffered from purulent or purulent blood secretion. Fistula formed in two cases and incision and drainage sites were not healed in one case. According to the bacterial culture results, above symptoms were accorded with clinical diagnosis of prosthesis infection. The prosthesis was remained for debridement. Vacuum sealing drainage was performed. Iodophor douche (30-50 mL) was conducted every day. The drainage tube at proximal end was occluded for 30 minutes, and then vacuum sealing drainage was performed. All patients were regularly followed up to assess the therapeutic effects of vacuum sealing drainage combined with prosthesis infection after replacement.  RESULTS AND CONCLUSION: (1) Except that one case was still in treatment, one case was dead, and one case of tumor prosthesis was failure and finally amputated, the remaining six patients were healed. (2) The time of vacuum sealing drainage and iodophor douche was 10 to 84 days, with the median time of 57 days. No adverse reactions or complications occurred. All healed patients were followed up for 12-60 months, without recurrence. (3) These results indicated that vacuum sealing drainage combined with iodophor douche retained the prosthesis to the greatest degree, is simple, safe, and effective for the infection after artificial joint replacement, needs a low cost, and is a kind of therapy for prosthesis infection after artificial joint replacement. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

Select

Multiple linear regression analysis of hip function and vitamin D levels before and after hip arthroplasty Zhang Wei, Tang Zai-xiang, Geng De-chun, Zhu Feng, Dong Han-qing, Wang Yi-jun, Xu Yao-zeng 2016, 20 (44):  6557-6563.  doi: 10.3969/j.issn.2095-4344.2016.44.003 Abstract ( 367 )   PDF (1078KB) ( 340 )   Save BACKGROUND: The incidence of low serum level of vitamin D in patients undergoing hip arthroplasty and its impact has not been reported in China, indicating that it has not been brought to the forefront. OBJECTIVE: To determine the prevalence of low serum level of vitamin D in patients before total hip arthroplasty and its relationship with the hip function scores. METHODS: Forty-eight hips from 48 patients undergoing primary hip arthroplasty from July 2013 to August 2014 in the First Affiliated Hospital of Suzhou University were enrolled. According to the serum level of vitamin D, patients were assigned to low-level (< 20 μg/L) and high-level (20 ≥ μg/L) groups. The general information of patients, the hip function scores before and after replacement at the last follow-up in the two groups were observed and compared. The relationship between the serum level of vitamin D and the hip function scores before and after replacement was analyzed by multiple linear regression analysis. And the average follow-up was 12 months (11-14 months). RESULTS AND CONCLUSION: (1) The incidence of low vitamin D level was 82% (20 ng/mL serving as standard). (2) Compared with patients with high vitamin D level, patients with low level of vitamin D had lower preoperative Harris scores and Merle D´Aubigne-Postel score (P < 0.05), and also at the last follow-up (P < 0.05. (3) Based on the preoperative and postoperative Harris, the multiple linear regression analysis showed that there was a positive correlation between the level of vitamin D and Harris score both preoperatively and postoperatively (P < 0.05). (4) These results suggest that there is a higher incidence of low level of vitamin D in patients undergoing arthroplasty, and hip function scores before and after replacement in patients with low level of vitamin D are lower than the high level patients. Moreover, there is a positive correlation between the level of vitamin D and the hip joint function scores. Therefore, it is advisable to supplement vitamin D and calcium preoperatively, and the level of vitamin D will be helpful for disease assessment and prognosis. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | Related Articles | Metrics

Select

Blood loss in primary total knee replacement with intra-articular injection of tranexamic acid and presurization Chen Qun-qun, Chen Jian-fa, Zhou Chi, Dong Lu-jue, Huo Shao-chuan, Wang Hai-bin 2016, 20 (44):  6564-6569.  doi: 10.3969/j.issn.2095-4344.2016.44.004 Abstract ( 344 )   PDF (1369KB) ( 496 )   Save BACKGROUND: Tranexamic acid is extensively used in the primary total knee replacement, but there are many different methods. OBJECTIVE: To explore the efficacy and safety of the intra-articular injection of tranexamic acid with pressurization in reducing the blood loss of primary total knee replacement. METHODS: Totally 56 patients undergoing unilateral total knee arthroplasty were enrolled and randomly divided into two groups. Patients were given the intra-articular injection of 100 mL of saline solution dissolving 2.0 g of tranexamic acid with large pad pressure bandaging the knee, and 4-hour drainage tube close, and then underwent negative pressure suction (experimental group); differently, the controls were given the normal pad bandage group. The drainage tube was removed within 48 hours after replacement. The patient blood routine examination was performed at the 3rd day, and at the same time, the volume of drainage was recorded; and the color Doppler ultrasound in ipsilateral lower extremity veins was conducted to observe the incidence of thrombosis at 4-5 days. RESULTS AND CONCLUSION: (1) The total blood loss, postoperative dominant blood loss, and hidden blood loss in the experimental group were significantly less than those in the control group (P < 0.05). (2) No significant difference was found in the incidence of postoperative thrombosis between two groups (P > 0.05). (3) These results indicate that the intra-articular injection of tranexamic acid with pressurization can significantly reduce the postoperative blood loss in the primary total knee arthroplasty, without increasing the risk of deep vein thrombosis. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

Select

Posterior cervical open-door expansive laminoplasty with mini-titanium plate: correlation between cervical sagittal alignment and repair effect Gu Yong, Wang Qiang, Xin Tian-wen, Yang Hui-lin, Chen Liang 2016, 20 (44):  6570-6576.  doi: 10.3969/j.issn.2095-4344.2016.44.005 Abstract ( 430 )   PDF (1312KB) ( 304 )   Save BACKGROUND: Posterior cervical open-door expansive laminoplasty is one of the simple and effective methods to treat cervical spinal diseases, has satisfactory results but low complications. However, the imbalance of sagittal plan, loss of lordosis or axial pain is often reported recently.    OBJECTVE: To analyze the correlation between cervical sagittal alignment and clinical outcomes after laminoplasty. METHODS: Between January 2011 and June 2015, 122 cases of cervical spinal disease, who were treated with open-door expansive laminoplasty with mini-titanium plate, were retrospectively analyzed. Clinical outcomes were evaluated by Japanese Orthopaedic Association, Neck Disability Index and Visual Analogue Scale. Radiographic results were assessed by C2-7 Cobb angle, C2-7 sagittal vertical axis and C7 slope. The correlation between sagittal alignment and clinical outcomes were analyzed. RESULTS AND CONCLUSION: (1) All patients were followed up for 7-32 months. (2) Japanese Orthopaedic Association, Neck Disability Index and Visual Analogue Scale scores were improved in the final follow-up (all P < 0.001). No significant difference in upper limb Visual Analogue Scale scores was determined (P=0.142). In the final follow-up, C2-7 sagittal vertical axis increased (P=0.036), but neither the C2-7 Cobb angle nor the C7 slope significantly changed (P=0.092, P=0.184). (3) There were no correlations between sagittal alignment parameters (C2-7 Cobb angle, C2-7 sagittal vertical axis and C7 slope) and clinical outcomes (Japanese Orthopaedic Association, Neck Disability Index and Visual Analogue Scale) (all P > 0.05). (4) These findings indicated that posterior cervical open-door expansive laminoplasty with mini-titanium plate can significantly improve the neurological function of patients. However, there is no correlation between cervical sagittal alignment and clinical outcomes. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

Select

Biomechanical properties of retrograde interlocking intramedullary nail versus less invasive stabilization system plate in the repair of distal femoral fractures Zhang Hui-dong, Wang Jing-wei, Bai Jing 2016, 20 (44):  6577-6582.  doi: 10.3969/j.issn.2095-4344.2016.44.006 Abstract ( 275 )   PDF (1092KB) ( 228 )   Save BACKGROUND: Distal femoral fractures are mainly treated with less invasive stabilization system (LISS) plate or retrograde interlocking intramedullary nail fixation, but choosing which method is controversial, and studies on their biomechanical properties are few. OBJECTIVE: To compare the biomechanical stability of retrograde interlocking intramedullary nail and LISS plate fixation in the treatment of distal femoral fractures. METHODS: Twelve male cadaveric femurs were collected, and the injured, with abnormal bone density and osteonosus specimens were excluded through X-ray examination, followed by randomly divided into two groups. Models of AO type A3 supracondylar fracture were prepared, and were fixed with LISS plate and retrograde interlocking intramedullary nail, respectively. The compressive stiffness and displacement values under axial compression and loading of 100, 300 and 500 N, as well as the bending strength of the specimens under bending load were observed. RESULTS AND CONCLUSION: (1) The resistance to axial deformation capacity (compressive stiffness) of the LISS plate was superior to the retrograde interlocking intramedullary nail (P < 0.05); while the resistance to bending deformation capacity (flexural strength) of the retrograde interlocking intramedullary nail was not significantly greater than that of the LISS plate (P > 0.05). (2) Under axial compressive loading of 100, 300 and 500 N, the displacement values of LISS plate were significantly less than those of the retrograde interlocking intramedullary nail (P < 0.05). (3) In conclusion, in the distal femoral fracture fixation, the stiffness of the retrograde interlocking intramedullary nail is low. While the LISS plate not only has certain deformation, but also has strong rigidity with firm internal fixation, which provides excellent biological environment for fracture healing; thus it is a reliable treatment for distal femoral fractures. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

Select

Viper system and pedicle screw fixation for treating thoracolumbar compression fractures Xu Jian-da, Gao Yi, Zhao Hong, Peng Li-bo, Zheng Chong, Wang Bin, Qu Yu-xing, Zhao Jian-ning 2016, 20 (44):  6583-6589.  doi: 10.3969/j.issn.2095-4344.2016.44.007 Abstract ( 338 )   PDF (1725KB) ( 277 )   Save BACKGROUND: Thoracolumbar spine as highly concentrated stress, often prone to vertebral fractures. With the further development of the biomechanics and anatomical structure of the spine, posterior open reduction and internal fixation with pedicle screw has been widely accepted by clinicians. OBJECTIVE: To explore the clinical results and safety of percutaneous pedicle screw fixation system (Viper system) used in thoracolumbar compression fractures. METHODS: We retrospectively analyzed 40 patients with thoracolumbar compression fractures from Department of Orthopedics, Changzhou Traditional Chinese Medicine Hospital and Nanjing General Hospital of Nanjing Military Area Command of Chinese PLA from January 2013 to February 2014. According to the type of graft, patients were randomly divided into experiment group and control group, with 20 patients in each group. They were respectively subjected to Viper percutaneous pedicle screw fixation system and open reduction and pedicle screw fixation. RESULTS AND CONCLUSION: All vertebra got bone unions. Operative time and time to bone union were shorter in the experiment group than in the control group. Moreover, intraoperative blood loss was less in the experiment group than in the control group. Cobb’s angle, height percentage of leading edge and wedge angle were similar between the two groups. However, at 12 months after internal fixation, height percentage of leading edge was lower in the experiment group than in the control group. Visual Analogue Scale scores and Oswestry Disability Index were noticeably improved after fixation in both groups. Visual Analogue Scale scores and Oswestry Disability Index were lower in the experiment group than in the control group immediately after fixation. These results suggest that compared with open reduction and pedicle screw fixation, Viper percutaneous pedicle screw fixation system for thoracolumbar compression fractures can stably restore the structure and function of spine, and does not increase perioperative complications.  中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

Select

Bridging external fixation combined with Kirschner-wire fixation versus volar locked plate fixation for unstable fractures of the distal radius Lian Zhi-ming, Yang Jing, Zhang Tai-liang, Ma Chuang, Liu Qiang, Yang Guang-zhong 2016, 20 (44):  6590-6598.  doi: 10.3969/j.issn.2095-4344.2016.44.008 Abstract ( 293 )   PDF (1423KB) ( 467 )   Save BACKGROUND: The unstable distal radius fractures are clinically treated with external fixation, open reduction and internal fixation at present. These two methods have their advantages and disadvantages.  OBJECTIVE: To compare the radiological, clinical and functional outcomes of two groups of patients treated by bridging external fixation combined with Kirschner wire fixation versus volar locked plate for a displaced fracture of the distal radius. METHODS: We collected 68 cases of unstable distal radius fractures in the Department of Reparative and Reconstructive Surgery, First Affiliated Hospital of Xinjiang Medical University, China from October 2014 to April 2016. They were randomly assigned to two groups, with 34 in each group. Patients in the external fixation group received external fixator and Kirschner wire. Patients in the internal fixation group received volar locked plate. In the follow-up, outcomes were assessed by radiographic parameters, function parameters, and Cooney functional score between both groups. RESULTS AND CONCLUSION: (1) All patients were followed up. External fixation group was followed up for 12-16 months. Internal fixation group was followed up for 13-15 months. X-rays showed all fractures healed. (2) At 3 months postoperatively, significant differences in pronation, supination, extension and radial deviation were detected between the two groups (P < 0.05), and the internal fixation had more advantages. At 6 months, these differences had become reduced. The extension of the wrist and pronation were still better in the internal fixation group. However, there was no significant difference between the two groups between preoperatively and 12 months postoperatively (P > 0.05). The range of motion of the wrist was better in the internal fixation group, but no significant difference in the grip strength was determined between the two groups at any time points in 1-year follow-up. (3) These results demonstrated that compared with the external fixation, volar locked plate fixation showed better early recovery postoperatively. With time prolonged, clinical outcomes of both repair methods tended to be consistent.  中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

Select

Different fixations for intertrochanteric fracture affect proximal femur stress: a finite element analysis Jiang Zi-wei, Huang Feng, Zheng Xiao-hui, Hu Qun-sheng, Pang Zhi-hui, Zhou Guang-quan, Li Yue 2016, 20 (44):  6599-6605.  doi: 10.3969/j.issn.2095-4344.2016.44.009 Abstract ( 385 )   PDF (1529KB) ( 854 )   Save BACKGROUND: The mechanical characteristics of intramedullary and intramedullary fixations for treating intertrochanteric fracture were hot research of finite element, but there was few comparative research on tension side and pressure side of proximal femur. In our study, we found that the distribution of the stress zone was important indication to researches on intertrochanteric fracture and internal fixation design. OBJECTIVE: To explore the effects of intramedullary and extramedullary fixations for treating intertrochanteric fracture on pressure side and tensile side of proximal femur. METHODS: CT scan and Mimics modeling of volunteer’s femur were conducted, and the model Evans type I intertrochanteric fracture was constructed and treated with proximal femoral nail antirotation and dynamic hip screw respectively. The stress condition of proximal femur in weight status was simulated. The Abaqus 6.13 was used for finite element analysis, and the tension side and pressure side of proximal femur in both fixations were also analyzed. RESULTS AND CONCLUSION: (1) The stresses of compressive side and tensile side in proximal femoral nail antirotation group were both less than that in dynamic hip screw group. The stress of proximal femur in proximal femoral nail antirotation group was more similar to that in physiological status. (2) These findings verified that for treating intertrochanteric fracture, intramedullary fixation exerted better mechanical behavior than extramedullary fixation. The protection of compressive side and tensile side of proximal femur had achieved by intramedullary fixation.  中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

Select

Finite element analysis of elderly femoral neck fracture based on LS-DYNA Li Peng-fei, Du Gen-fa, Lin Zi-ling, Pang Zhi-hui, Fan Yue-guang, He Xiang-xin, Sun Wen-tao,Chen Jin-lun 2016, 20 (44):  6606-6611.  doi: 10.3969/j.issn.2095-4344.2016.44.010 Abstract ( 394 )   PDF (1397KB) ( 351 )   Save BACKGROUND: With the increasing of aging, the incidence and mortality of osteoporotic hip fracture will rise. It is of great significance to study the pathogenesis and preventing method. At present, finite element analysis can be used to judge fracture, only for the distribution trend of fracture failure in the starting point or section view, but it cannot completely reflect actual situation of fracture. OBJECTIVE: To build the fracture model of the femoral neck fracture caused by falling-induced external force based on the finite element analysis LS-DYNA software, and to evaluate the effect of rupture.  METHODS: CT image data of one case of elderly femoral neck fracture were collected. Using Mimics software, region growth of the contralateral area, cavity filling, editing, rebuilding the contralateral proximal femur model were conducted. Data were imported in Hypermesh and LS-DYNA software for meshing, and defining material properties. The failure parameters and interfacial properties were set. The load and force boundary constraints simulating the falling were simulated. The model of femoral neck fracture was calculated. Rupture effect was evaluated. RESULTS AND CONCLUSION: (1) The validity of contralateral proximal femur three-dimensional model was verified. Based on the finite element analysis software LS-DYNA, the femoral neck fracture model matched the actual fracture line to a degree of close to 83%. (2) Above results confirmed that based on the finite element analysis, LS-DYNA software can well simulate the femoral neck fracture, which provides experimental basis to the exploration of femoral neck fracture classification mechanism caused by different falling-induced external forces. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

Select

Biomechanics characteristics of four anterior cervical reconstructive techniques in the surgical management of multilevel cervical spondylotic myelopathy: a finite element model study Li Zhong-hai, Lin Bin, Tang Jia-guang, Ren Dong-feng, Li Li, Wu Wen-wen, Hou Shu-xun 2016, 20 (44):  6612-6619.  doi: 10.3969/j.issn.2095-4344.2016.44.011 Abstract ( 329 )   PDF (2067KB) ( 190 )   Save BACKGROUND: Surgical treatment is commonly used for decompressing the spinal cord in multilevel cervical spondylotic myelopathy, but the optimum anterior cervical reconstructive method has not been determined. OBJECTIVE: To compare and analyze the biomechanical characteristics of four anterior cervical reconstructive techniques in the surgical management of multilevel cervical spondylotic myelopathy utilizing the three-dimensional finite element model. METHODS: A three-dimensional ?nite element model of an intact C2–7 segment was developed and validated based on healthy adult male CT images. Four additional models were developed from the fusion model, including anterior cervical discectomy and fusion, anterior cervical corpectomy and fusion, anterior cervical hybrid decompression and fusion and anterior cervical discectomy and fusion with Cage alone. Von Mises stresses on the plate and the disc of adjacent levels (C2/3, C6/7) were comparatively analyzed.  RESULTS AND CONCLUSION: (1) The C2/3 disc stress in flexion, extension, lateral bending and rotation condition was significantly higher than the C6/7 disc in 4 anterior cervical reconstructive techniques, and the adjacent disc stress (C2/3, C6/7) was lowest in the anterior cervical discectomy and fusion with Cage alone, and highest in the anterior cervical corpectomy and fusion. (2) The stress at the plate-screw interface was highest in the anterior cervical corpectomy and fusion, and lowest in the anterior cervical discectomy and fusion. (3) In conclusion, among the four anterior cervical reconstructive techniques for multilevel cervical spondylotic myelopathy, the anterior cervical discectomy and fusion with Cage alone makes little effect on the adjacent disc stress, which might reduce the incidence of adjacent segment disease after fusion. However, the accompanying risk of the increased incidence of cage subsidence should never be neglected. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

Select

Morphological characteristics of thoracic vertebrae in children aged from 10 to 12 years with three-dimensional digital reconstruction Liu Xiang-wei, Wang Xing, Zhang Shao-jie, Li Zhi-jun, Liu Ying, Shi Jun 2016, 20 (44):  6620-6628.  doi: 10.3969/j.issn.2095-4344.2016.44.012 Abstract ( 422 )   PDF (1433KB) ( 447 )   Save BACKGROUND: Articular process of joint is an important bony structure to maintain the spinal stability and normal physiological activities. Clinical study found that bilateral articular process asymmetry is also one of the causes of vertebral degeneration, but the existing research mainly focuses on the adult, and give priority to with cervical vertebra and lumbar vertebra. OBJECTIVE: To explore the morphological and developmental characteristics of thoracic facet joints and bony structures of 10 to 12-year-old children and compare with data of adults. METHODS: A total of 30 normal cases aging from 10 to 12 years were admitted into this study. No cases experienced bone destruction, deformity, fractures, or tumors, and spine surgery was not involved in. DICOM 3.0 data of multi-slice spiral CT (0.625-1.25 mm), ranging from T1 to T12, were used for three-dimensional reconstruction, measurement and statistical analysis. RESULTS AND CONCLUSION: (1) Joint width overall trends in “V”. Joint surface height from T1 to T12 increased gradually with the increase of the operation sequence. (2) The joint thickness from T1 to T12 showed a gradually increasing trend with the increase of the job sequence; articular process under the joint thickness was gentle. In the left and right sides of the upper and lower joints, joint surface width, height, and thickness did not show significant difference in addition to the significant difference between the individual vertebral body. Joints spacing on the side and there was no significant difference between upper and lower, articular process spacing between sides showed an increasing trend with the increase of operation sequence; upper and lower joints spacing increased with the job sequence, and showed wide “U” shape. (3) These results confirmed that the application of three-dimensional reconstruction techniques can display shape and characteristics of each vertebral body clearly and intuitively and improve measurement accuracy. Width and height of facet joints in 10-12-year-old school children were overall smaller than those of adults. The distance between upper and lower facet joints changed a little. Distance between left and right facet joints increased from T1 to T12, which complies with the growth and development of children. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

Select

Establishment and volume estimation of three-dimensional digital model of osteoarthrosis of the femoral head Liu Hong-bin, Zhao Han-qing, Shi Yue, Hou Li-jun, Wang Zhong-xun 2016, 20 (44):  6629-6635.  doi: 10.3969/j.issn.2095-4344.2016.44.013 Abstract ( 530 )   PDF (1311KB) ( 272 )   Save BACKGROUND: Core decompression and autogenous bone grafts are widely used in treatment of early avascular necrosis of femoral head. According to the report, the success rate of this therapy has obvious difference; the reasons may be related to inaccurate puncture location and secondary damnification of repeated puncture.  OBJECTIVE: To reconstruct three-dimensional model of femoral head necrosis by Mimics software for reappearance of lesions in the necrotic area to realize measurement of necrotic area of the femoral head and estimation of its volume. METHODS: We restructured images by using multi-slice spiral CT Syngommvvp VE23A workstation, Inspace software and NeuroDSA software. Hip CT data in DICOM format were imported into Mimics 13.0 software systems. Necrotic area of the femoral head was reconstructed with Mimics SimuIation software to truly reproduce the integrated form, scope and stereochemical structure of the necrotic area so as to achieve the measurement of the necrotic area of the femoral head and the volume estimation. We designed the best core decompression channel, simulated core decompression surgery, so that the patients could refer to the best simulated decompression path in the operation of core decompression. RESULTS AND CONCLUSION: (1) Among 36 patients (48 hips) with avascular necrosis of femoral head, there were phase I in 8 hips, accounting for 17%, phase II in 28 hips, accounting for 58%, and phase III in 12 hips, accounting for 25%. (2) The volume of necrotic area was (1 475.48±647.342) mm3 in the phase I, (4 571.77±2 344.55) mm3 in the phase II, and (4 836.46±2 969.33) mm3 in the phase III. (3) We simulated the core decompression based on the radius of the sphere of the necrotic area as parameter in the Mimics Simulation software module, and then completely cleared the necrotic area. (4) Surgery can more clearly understand information and stereochemical structure of the necrotic area with Mimics software to simulate the core decompression. It is the theoretical basis of operation. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

Select

Development and application of special-purpose grafter by femoral head decompression combined with bone marrow mesenchymal stem cells transplantation based on three-dimensional printing technology Wang Jian-ji, Yang Long, Li Jing, Sun Qi, Zuo Wei-min, Ren Qi-feng, Sun Yu, Wu Zhan-yu, Zou Qiang, Ma Min-xian, Ye Chuan 2016, 20 (44):  6636-6642.  doi: 10.3969/j.issn.2095-4344.2016.44.014 Abstract ( 373 )   PDF (1462KB) ( 450 )   Save BACKGROUND: Autologous tissue-engineered bone marrow mesenchymal stem cells (BMSCs) transplantation is one of the most common methods of treating early osteonecrosis of femoral head, but now there is still no any special-purpose grafter available in the market. Such surgical transplantation is a laborious, time-consuming and tedious process, which goes against its clinical promotion. OBJECTIVE: To develop a supporting, efficient, special-purpose grafter, to solve the difficulty in stem cells transplantation during core decompression of femoral head. METHODS: CAD software was used to perform solid modeling for this special-purpose grafter and print them by three-dimensional (3D) fast printing technology. The performance of this special-purpose grafter was tested by femoral head core decompression combined with BMSCs transplantation. It was compared with traditional surgical instrument in terms of duration of operation, intraoperative blood loss, visual analogue scale (VAS) of stem cell/biological fiber collagen complex omission amount and doctor’s satisfaction score. RESULTS AND CONCLUSION: (1) A kind of special-purpose grafter was developed by 3D printing technology rapidly. (2) Compared with the control group, duration of operation, intraoperative blood loss, VAS scores and doctor’s satisfaction scores were significantly improved in the trial group (P < 0.05). (3) CAD software combined with 3D printing technology is a highly efficient means for front-line clinicians to perform independent development. The research and development of this special-purpose grafter provides a perfect solution to the laborious, time-consuming and tedious process of cell/biological collagen fiber transplantation. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

Select

Virtual reality of acupuncture manipulation in digital virtual human Jiang Yu-chen, Jiang Jun, Wang Fu-bo, Guo Hai-dong, Shao Shui-jin, Yan Zhen-guo, Miao Peng 2016, 20 (44):  6643-6648.  doi: 10.3969/j.issn.2095-4344.2016.44.015 Abstract ( 443 )   PDF (988KB) ( 187 )   Save BACKGROUND: The three-dimensional structure of acupoint anatomy was integrated into the teaching of acupuncture manipulation. Combined with the implementation and application of the acupuncture and moxibustion in digital virtual human, it can greatly improve the teaching effect and learning interest. OBJECTIVE: To investigate the acupuncture virtual human with integration of virtual reality force feedback technology and tissue deformation. METHODS: Using virtual reality technology, with computer as the core, we generated a specific range of virtual environment with realistic visual, auditory and tactile integration, collected clinical expert acupuncture technique, matched the sensing equipment that can reflect the intensity, displacement and speed sensing of acupuncture. Based on image segmentation of virtual human, we constructed human tissue mechanics model, built virtual acupuncture-force-feedback system, and faithfully transmitted to the operator by a force feedback device. On one hand, based on VOXEL-MAN virtual human development platform, we finished the three-dimensional browser redevelopment of the science of acupuncture and moxibustion of Shu acupoint, which provided visual perception for people. On the other hand, based on modern biomechanics theory, we established models by graphics and image processing technology and force feedback technology. The stress process of the structure of each layer in the acupuncture point area was given to people in a sense of touch by the manner of virtual reality and force feedback. RESULTS AND CONCLUSION: With the man-machine interactive operation platform of virtual acupuncture force feedback system, operator could see the dynamic process of acupuncture needle into human body, and could feel the real counterforce in the control terminal of force feedback instrument. By operating acupuncture needle in virtual environment of force feedback instrument, acupuncture was performed in virtual human. The system meets the two requirements: the feedback changes produced by tissue interaction were similar to real acupuncture feedback force data measured by instrument. The acupuncture needle entered into different tissues, a sense of power changed significantly; there was progressive feeling with different layers, reaching a realistic experience. During the whole training, the image was smooth; virtual needle was responsive, which better meets the requirements of virtual reality.  中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

Select

X-ray implanted in fixing the fracture localization and navigation in orthopedics Guo Hong-bin, Guo Ying-xin, Yu Wei, Ding Chun-ping, Cai Zhong-li 2016, 20 (44):  6649-6654.  doi: 10.3969/j.issn.2095-4344.2016.44.016 Abstract ( 291 )   PDF (959KB) ( 241 )   Save BACKGROUND: The traditional orthopedic fixation by C-arm positioning surface is completed, but the large C-arm injury on the human body and the long fixed time increase the suffering of patients. OBJECTIVE: To investigate the X-ray fixed in position within the orthopedic implants, navigation and effect. METHODS: Twenty-six New Zealand white rabbits were randomly divided into C-arm machine group and X-ray group, with 13 in each group. Rabbits in both groups were used to simulate soft tissue foreign body localization, intramedullary nail implantation at distal fracture end and spinal pedicle screw entry point position. In the C-arm machine group, positioning navigation was conducted with C-arm machine. In the X-ray group, X-ray positioning navigation was used. The positioning and navigation effects were compared between the two groups.  RESULTS AND CONCLUSION: (1) Compared with the C-arm machine group, the time required for navigation in the X-ray group targeting soft tissue foreign body localization, fracture distal locking intramedullary nail implantation and pedicle screw spinal needle point location was significantly shorter (P < 0.05); navigation displacement and deviation produced were significantly less (P < 0.05). (2) These findings suggested that the X-ray positioning for orthopedic fixation method is relatively simple, with high availability, and can obtain a high performance-price ratio. Meanwhile, the X-ray localization can improve accuracy and shorten the fixed time. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

Select

Minimally invasive treatment of proximal humerus fractures with locking compression plate improves shoulder function in older patients: study protocol for a prospective randomized controlled trial Wu Tao, Zhang Guo-qiu 2016, 20 (44):  6655-6660.  doi: 10.3969/j.issn.2095-4344.2016.44.017 Abstract ( 322 )   PDF (848KB) ( 281 )   Save BACKGROUND: Manual reduction or traditional steel plate fixation is commonly used for repair of proximal humerus factures in older patients, because of poor stability, making these injuries prone to fracture malunion. While open reduction with steel plate fixation has a better outcome than closed reduction, the stability of internal fixation is still less than satisfactory. Clinical studies have shown that minimally invasive treatment with locking compression plates has presented good clinical results in terms of fixation stability, bone healing, and functional recovery. Therefore, we hypothesize that use of a locking compression plate will provide better stability and that biocompatibility will potentiate fracture healing and shoulder function recovery in older patients with proximal humerus fractures. OBJECTIVE: To observe the improvement of minimally invasive treatment with locking compression plates in older patients with proximal humerus fractures. MEHTODS: This prospective, single-center, randomized controlled clinical trial will be completed at the Department of Joint Surgery, Affiliated Hospital of Qinghai University in China. Eighty-two older patients with proximal humerus fractures will be enrolled and equivalently assigned to two groups. In the test group, patients will undergo closed reduction via a lateral approach to the shoulder followed by locking compression plate fixation using a minimally invasive technique, and those in the control group will be subjected to closed reduction via a lateral approach to the shoulder followed by conventional steel plate fixation using a minimally invasive technique. All patients will be followed up for 6 months. The primary outcome will be recovery of shoulder function as indicated by clinical outcome scores according to the Neer classification system for proximal humeral fractures 6 months after surgery. The secondary outcomes will include the operation time; intraoperative blood loss; postoperative hospital stay; fracture healing time; clinical outcome scores according to the Neer classification system 0.5, 1, and 3 months after surgery; visual analogue scale scores 1 and 3 days and 1 and 2 weeks after surgery to assess pain; scores of the Medical Outcomes Study 36-item short form health survey 0.5, 1, 3, and 6 months after surgery to assess quality of life; and X-ray examinations 0.5, 1, 3, and 6 months after surgery to assess fracture healing. The experiment was approved by the Ethics Committee of Affiliated Hospital of Qinghai University of China (approval No. QHY1005D). Participants were informed to the test content and treatment process, and signed informed consent. DISCUSSION: This study protocol represents an attempt to objectively choose appropriate methods for internal fixation of proximal humerus fractures in older patients by comparing locking compression plate and conventional steel plate fixation to improve shoulder function. TRIAL REGISTRATION: This trial was registered with the ClinicalTrials.gov identifier: NCT02784522; on 19 May 2016.  中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 References | Related Articles | Metrics

Select

Cobalt alloy pedicle screw implantation for treatment of severe kyphotic deformity in spinal tuberculosis: study protocol for a self-control trial Hou Yu, Yang Wen, Yang Fan, Bu Hong-jian, Wang Lin-jie, Liang Zhi-xing, Sun Bo, Shen Zhi-kun 2016, 20 (44):  6661-6666.  doi: 10.3969/j.issn.2095-4344.2016.44.018 Abstract ( 307 )   PDF (967KB) ( 300 )   Save BACKGROUND: There is evidence that internal fixation through an anterior or posterior approach for treatment of severe kyphotic deformity in spinal tuberculosis exhibits good curative effects. However, few prospective, long-term follow-up case control studies are reported. OBJECTIVE: To investigate the efficacy and safety of cobalt alloy pedicle screw implantation for treatment of severe kyphotic deformity in spinal tuberculosis. METHODS/DESIGN: This is a prospective, single-center, self-control, open-label trial, which will be performed at the Affiliated Hospital of Hebei University, China. Eighty-four patients with severe kyphotic deformity in spinal tuberculosis will be included according to the diagnosis criteria. Among 52 patients with tuberculosis of the thoracic spine, 28 will undergo surgery through a posterior approach, and 24 through an anterior approach. According to the Frankel Grade classification, grade C, D and E spinal cord function will be assessed in 8, 31 and 13 patients, respectively. Surgery through a posterior and anterior approach will be respectively performed in half of 32 patients with tuberculosis of the lumbar spine. Grade C, D and E spinal cord function will be assessed in 7, 14 and 11 patients, respectively. The primary outcome measure of this study will be the Cobb angle at the thoracic spine segments before and 2 years after surgery, which will be used to evaluate the angle of the spine curvature at the thoracic segments. The secondary outcome measures will be X-ray scan or MRI findings before and 2 years after surgery, which will be used to evaluate vertebral fusion after internal fixation; and Frankel Grade before and 2 years after surgery, which will be used to evaluate recovery of spinal cord function after injury. Other outcome measures will include multiple logistic regression analysis results of the factors that influence patient's curative effects and the incidence of adverse events 2 years after surgery. The trial protocol has been approved by the Ethics Committee, Affiliated Hospital of Hebei University, China and will be performed in strict accordance with the Declaration of Helsinki, formulated by the World Medical Association. Signed informed consent regarding the trial protocol will be obtained from each participant. DISCUSSION: This study is to validate that cobalt alloy pedicle screw implantation shows precise curative effects in the treatment of severe kyphotic deformity in spinal tuberculosis and to analyze through what approach, posterior or anterior, internal fixation will be more beneficial to surgery performance. The outcomes of this study will provide objective long-term follow-up evidence for internal fixation treatment of severe kyphotic deformity in spinal tuberculosis in the clinic. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 References | Related Articles | Metrics

Select

Relationship of cell membrane microparticles CD31 and CD54 with alcohol-induced avascular necrosis of the femoral head: study protocol for a randomized controlled trial Yang Yun, Fan Hai-yan, Huang Jian, Ma Zhong-ping, Zhang Zhi-feng 2016, 20 (44):  6667-6672.  doi: 10.3969/j.issn.2095-4344.2016.44.019 Abstract ( 314 )   PDF (1061KB) ( 199 )   Save BACKGROUND: Cell membrane microparticles CD31 and CD54 lead to microvascular injury in the femoral head by mediating vascular inflammatory response, promoting blood clotting, affecting vasomotion and promoting vascular endothelial injury. Studies have verified that membrane particles play an important role in steroid-induced necrosis of the femoral head, but there is no studies concerning relationship between microparticles and alcohol-induced avascular necrosis of femoral head. METHODS/DESIGN: This is a randomized controlled animal study. Healthy male Wistar rats will be randomly assigned to two groups. In the model group, rats will be intragastrically administered hard liquor for 6 consecutive months to prepare models of alcohol-induced avascular necrosis of the femoral head. Blank controls will be intragastrically given an equal volume of physiological saline. In 1-6 months of intervention, six rats will be randomly selected from each group every month. Blood will be collected separately. Flow cytometry will be used to detect serum cell membrane particles CD31, CD54 levels. Bilateral femoral head will be fixed, decalcified, embedded in wax, and then sections. After hematoxylin-eosin staining, empty bone lacuna will be quantified under a light microscope to identify femoral head necrosis. Verhoff’s staining and MSB microthrombosis staining will be used to observe microvascular injury and microvascular thrombosis in the femoral head, and to analyze the correlation of CD31 and CD54 levels with femoral head necrosis, vascular endothelial injury and microvascular thrombosis. DISCUSSION: This study will investigate the effects of CD31 and CD54 on alcohol-induced avascular necrosis of the femoral head, explore the pathogenesis of alcohol-induced avascular necrosis of the femoral head, provide a new theoretical basis for early diagnosis and early treatment, and may provide a new target for its treatment. ETHICS APPROVAL: The protocol has been approved by the Animal Experimental Ethics Committee of Inner Mongolia Medical University (approval number YKD2016154). Experimental procedures and materials of rats will be in accordance with the Guide for the Care and Use of Laboratory Animals, which is consistent with the guide of National Institutes of Health.  中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Related Articles | Metrics

Select

Research progress of bone microarchitecture and microdamage detection Xu Can, Li Ming-qing, Wang Cheng-gong, Li Kang-hua, Liu Hua 2016, 20 (44):  6673-6681.  doi: 10.3969/j.issn.2095-4344.2016.44.020 Abstract ( 547 )   PDF (1633KB) ( 305 )   Save BACKGROUND: Bone fragility and poor bone quality due to osteoporosis are a major and increasing concern. Bone microarchitecture and microdamage, the important factors of bone quality, their detection technology and instrument have experienced a long development process. OBJECTIVE: To give a brief introduction of the concept of the bone microarchitecture and microdamage, then to summarize the research progress of their detective methods. METHODS: PubMed and CNKI databases were retrieved for reviews and articles related to bone microarchitecture and microdamage published from January 1990 to June 2016 using the keywords of “bone microarchitecture, bone microdamage and detect/detective/detecting” in Chinese and English, respectively. Finally a total of 65 articles were selected for overview. RESULTS AND CONCLUISON: (1) Bulk staining is a quick and useful way to confirm and assess linear microcracks and diffuse damage. Micro-CT and confocal microscopy allow visualization at the micron scale, and are useful tools to understand the three-dimentional nature of bone microdamage. Scanning electron microscope lacks the ability to investigate large regions of microdamage, but allows users to probe in extensive details at the nano scale. (2) Ultimately, we recommend the use of multiple imaging modalities according to the experimental needs to obtain useful information about bone quality and microdamage formation, across the scales of hierarchy in bone. 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics

Select

Auxiliary reference significance of Blumensaat line for knee joint disease Cheng Xiang-yun, Zhang Sheng-xiao, Cao Wan-quan, Wang Gang, Lu Yan-hui, Zhu Hong, Yang Zi-quan 2016, 20 (44):  6682-6688.  doi: 10.3969/j.issn.2095-4344.2016.44.021 Abstract ( 4843 )   PDF (1282KB) ( 601 )   Save BACKGROUND: With the development of sports medicine and research of radiologic imaging techniques, Blumensaat line (the radio-opaque line at the roof of the intercondylar notch) has been paid increasing attention. Blumensaat line is considered as measurement indexes of knee diseases. Taking advantage of the Blumensaat line, many surgeons and radiography physicians are trying to diagnose some knee diseases. OBJECTIVE: According to the knowledge about Blumensaat line in auxiliary diagnosis of knee disease, we hoped that it will have a wide application in clinic. METHODS: A computer-based online search of CBM, CNKI, Wangfang Database and PubMed between 2000 and 2015 was performed for articles addressing Blumensaat line. We summarized its application as different diagnostic indicators. The key words were patella alta, Blumensaat line, anterior cruciate ligament (ACL) injuries and ACL reconstruction. Thirty-nine studies were accorded with the inclusion criteria. RESULTS AND CONCLUSION: Blumensaat line represents the tangentially hit part of the roof in the intercondylar fossa. The line can be used for diagnosing ACL injuries and directing ACL restruction. (1) Blumensaat line and patella alta: Patella heights can be measured with the use of Blumensaat method, modified Blumensaat method and modified Blumensaat ratio. Modified Blumensaat ratio was found by Japanese researchers in 2014 and it is efficient. (2) Blumensaat line and ACL injuries: Blumensaat angle is formed by Blumensaat line and ACL. If this angle is negative or it is greater than 15°, we can draw a conclusion that the ACL was hurt. (3) Harner’s method can be used for choosing an accurate isometric point and a perfect bone tunnel’s angel in ACL reconstruction.  中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程 Figures and Tables | References | Related Articles | Metrics